Predictive analysis of serum periostin levels on the treatment responsiveness in children with cough variant asthma

doi:10.3877/cma.j.issn.1674-6902.2025.04.025

Abstract

Abstract:

Objective

To analyze the predictive value of serum periostin levels for early treatment responsiveness in children with cough variant asthma (CVA).

Methods

Fifty-nine children with CVA admitted to our hospital from June 2021 to November 2024 were enrolled. All children received inhaled corticosteroids combined with long-acting β₂ agonists (ICS/LABA) for 28 days. Forty-eight children with good treatment responsiveness were assigned to the control group, and 11 children with poor treatment responsiveness were assigned to the observation group. Clinical data were compared between the two groups. Multivariate logistic regression was used to identify influencing factors, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of serum periostin levels for poor treatment responsiveness in CVA children.

Results

The observation group showed significantly higher values than the control group in: disease duration (2.48±0.41 months vs. 2.06±0.32 months), proportion with a history of recurrent respiratory infections 9 cases (81.82%) vs. 18 cases(37.50%), serum periostin levels (82.29±2.22 ng/ml vs. 78.33±4.42 ng/ml), and fractional exhaled nitric oxide (FeNO) (21.28±3.74 ppb vs. 18.33±1.80 ppb) (P<0.05). Multivariate logistic regression analysis revealed that serum periostin level (OR=1.346, 95%CI: 1.028~1.761) and FeNO(OR=1.670, 95%CI: 1.068~2.611) were independent risk factors for poor treatment responsiveness in CVA children (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for predicting poor treatment responsiveness was 0.807 for serum periostin, 0.769 for FeNO, and 0.837 for the combination.

Conclusion

The level of serum periostin can predict the treatment responsiveness of children with CVA, which is of clinical significance.

Key words: Cough variant asthma, Serum periostin, Therapeutic reactivity, Predictive value

Xiaohong Zhang, Xin Li, Ronghua Zhao, Ningning Han. Predictive analysis of serum periostin levels on the treatment responsiveness in children with cough variant asthma[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(04): 638-642.

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References 30

1	Zhan Wenzhi, Wu Feng, Zhang Yunhui, et al. Identification of cough-variant asthma phenotypes based on clinical and pathophysiologic data[J]. J Allergy Clin Immunol, 2023, 152(3): 622-632.
2	马融，胡思源，李新民，等. 黄龙止咳颗粒联合孟鲁司特钠咀嚼片治疗儿童咳嗽变异性哮喘多中心随机对照临床研究[J]. 中国实用儿科杂志，2023, 38(8): 601-607.
3	Diab Nermin, Patel Matthew, O′sByrne Paul, et al. Narrative review of the mechanisms and treatment of cough in asthma, cough variant asthma, and non-asthmatic eosinophilic bronchitis[J]. Lung, 2022, 200(6): 707-716.
4	杜敏，魏维，周光红，等. Th2倾向型典型哮喘与咳嗽变异性哮喘外周血单个核细胞基因表达谱的差异性研究[J]. 中国呼吸与危重监护杂志，2023, 22(6): 395-402.
5	Yi Fang, Jiang Ziyu, Li Hu, et al. Small airway dysfunction in cough variant asthma: prevalence, clinical, and pathophysiological features[J]. Front Physiol, 2021, 12(5): 761622.
6	陈晓纯，杨建雅，肖晶旻，等. 仙芪青龙方治疗咳嗽变异性哮喘肺肾两虚、风盛挛急证的随机、阳性对照、非劣效性临床试验[J]．中医杂志，2024, 65(20): 2109-2115.
7	Wen Lingmiao, Zhang Tinglan, Chen Fangfang, et al. Modified Dingchuan Decoction treats cough-variant asthma by suppressing lung inflammation and regulating the lung microbiota[J]. J Ethnopharmacol, 2023, 30(6): 116171.
8	高劲松，韩锦，黄伟，等. 疏金利肺汤辅助治疗咳嗽变异性哮喘对抗氧化物、NF-κB p65蛋白的变化研究[J]. 中华中医药学刊，2023, 41(7): 61-64.
9	Xiong Jian, Qi WenChuan, Yang Han, et al. Acupuncture treatment for cough-variant asthma: A Meta-analysis[J]. Evid Based Complement Alternat Med, 2021, 20(21): 6694936.
10	Park Sun H, Tsuzuki Shunsuke, Contino Kelly F, et al. Crosstalk between bone metastatic cancer cells and sensory nerves in bone metastatic progression[J]. Life Sci Alliance, 2024, 7(12): 147-149.
11	王岚滔，赵月华，冯晓晨，等. 急性支气管炎患儿血清骨膜蛋白、SCCA表达及临床意义分析[J]. 临床和实验医学杂志，2024, 23(12): 1313-1317.
12	Yavuz Süleyman Tolga, Bagci Soyhan, Bolat Ahmet, et al. Association of serum periostin levels with clinical features in children with asthma[J]．Pediatr Allergy Immunol, 2021, 32(5): 937-944.
13	Morice Alyn H, Millqvist Eva, Bieksiene Kristina, et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children[J]. Eur Respir J, 2020, 55(1): 125-1129.
14	Cox Joshua K, Lockey Richard, Cardet Juan Carlos. Cough-Variant Asthma: A review of clinical characteristics, diagnosis, and pathophysiology[J]. J Allergy Clin Immunol Pract, 2024, 5(5): 168-170.
15	Zhu Ziyu, Wu Jiabao, Chen Wenjun, et al. Bibliometric analysis of cough variant asthma from 1993 to 2022[J]. J Asthma Allergy, 2024, 17(8): 517-537.
16	Joo Hyonsoo, Moon Ji-Yong, An Tai Joon, et al. Revised Korean Cough Guidelines, 2020: Recommendations and Summary Statements[J]. Tuberc Respir Dis (Seoul), 2021, 84(4): 263-273.
17	Ren Yuzhe, Li Xing, Zhang Yuanjie, et al. Xiaoqinglong decoction suppresses childhood cough variant asthma and inhibited the body inflammatory response by regulating IL-6/STAT3 signalling pathway[J]. Ann Med Surg (Lond), 2023, 85(11): 5469-5477.
18	Chen Zhe, Jin Kehan, Fang Zhangfu, et al. Sputum metabolomic signature and dynamic change of cough variant asthma[J]. Am J Respir Cell Mol Biol, 2024, 4(5): 167-171.
19	Rybka-Fraczek Aleksandra, Dabrowska Marta, Grabczak Elzbieta M, et al. Inflammatory phenotypes of cough variant asthma as response predictors to anti-asthmatic therapy[J]. J Inflamm Res, 2022, 15(10): 595-602.
20	Li Jun, Han Ying. Therapeutic effect of modified Xiaoqinglong Decoction on cough-variant asthma and immunological functioning in children[J]. Am J Transl Res, 2023, 15(2): 1360-1366.
21	Lai Kefang, Zhan Wenzhi, Wu Feng, et al. Clinical and inflammatory characteristics of the Chinese APAC cough variant asthma cohort[J]. Front Med (Lausanne), 2021, 8(8): 807385.
22	Deng Ruoxian, Li Changwei, Wang Xiao, et al. Periosteal CD68＋ F4/80＋ macrophages are mechanosensitive for cortical bone formation by secretion and activation of TGF-β1[J]. Adv Sci (Weinh), 2022, 9(3): e2103343.
23	Alikhani Mani, Alikhani Mona, Sangsuwon Chinapa, et al. Periosteum response to static forces stimulates cortical drifting: A new orthopedic target[J]. J World Fed Orthod, 2024, 13(6): 293-302.
24	Du Kun, Wang Min, Zhang Nan, et al. Involvement of the extracellular matrix proteins periostin and tenascin C in nasal polyp remodeling by regulating the expression of MMPs[J]. Clin Transl Allergy, 2021, 11(7): e12059.
25	Bao X, Liu B, Jiang Y, et al. Loss of SENP3 mediated the formation of nasal polyps in nasal mucosal inflammation by increasing alternative activated macrophage[J]. Immun Inflamm Dis, 2023, 11(2): e781.
26	李小丽，杜斯斯，张松，等. Clara细胞分泌蛋白16和骨膜蛋白与哮喘患儿维生素水平和疗效的相关性及对疗效的预测价值[J]. 中国临床药学杂志，2024, 33(11): 840-845.
27	刘思文，孙义田，贾同磊，等. 麻杏石甘汤治疗ACOS急性发作期的效果及对血清NGAL、Periostin水平的影响[J]. 四川中医，2024, 42(11): 100-103.
28	李德莲，杨鹏，王琳. FeNO联合总IgE、CXCL13检测对儿童支气管炎继发哮喘的意义[J/CD]. 中华肺部疾病杂志(电子版), 2022, 15(6): 838-840.
29	徐娅冬，李雅丽，黄魏宁. 呼出气一氧化氮对变应性鼻炎伴哮喘患者鼻用激素治疗的指导价值[J]. 中国耳鼻咽喉头颈外科，2023, 30(6): 398-400.
30	谢钰帆，沈海涛. 上海地区支气管哮喘合并睡眠呼吸暂停综合征患者FeNO、CRP和PCT水平变化及危险因素分析[J]. 公共卫生与预防医学，2023, 34(6): 95-98.

临床资料	观察组(n＝11)	对照组(n＝48)	t/χ²值	P值
病程[月，(±s)]	2.48±0.41	2.06±0.32	2.510	0.019
湿疹史[n(%)]	5(45.45)	30(62.50)	1.078	0.299
过敏史[n(%)]	7(63.64)	20(41.67)	1.740	0.187
咳嗽特征[n(%)]			3.463	0.063
夜间显著	3(27.27)	28(58.33)
白天显著	8(72.73)	20(41.67)
呼吸道反复感染史[n(%)]	9(81.82)	18(37.50)	7.082	0.008
血清生化指标
白细胞计数[×10⁹，(±s)]	6.25±1.11	6.37±1.08	0.325	0.750
C反应蛋白[mg/L，(±s)]	3.32±0.29	3.27±0.41	0.474	0.641
中性粒细胞[%，(±s)]	58.25±10.25	57.99±7.64	0.079	0.938
嗜酸性粒细胞[%，(±s)]	4.75±1.17	4.69±1.31	0.150	0.883
血清骨膜蛋白水平[ng/ml, (±s)]	82.29±2.22	78.33±4.42	2.877	0.006
气道功能指标
FEV[%，(±s)]	88.01±12.35	87.31±10.64	0.174	0.865
FVC[%，(±s)]	92.93±13.01	91.44±12.54	0.345	0.735
FeNO[ppb，(±s)]	21.28±3.74	18.33±1.80	3.911	0.000

临床资料	观察组(n＝11)	对照组(n＝48)	t/χ²值	P值
病程[月，(±s)]	2.48±0.41	2.06±0.32	2.510	0.019
湿疹史[n(%)]	5(45.45)	30(62.50)	1.078	0.299
过敏史[n(%)]	7(63.64)	20(41.67)	1.740	0.187
咳嗽特征[n(%)]			3.463	0.063
夜间显著	3(27.27)	28(58.33)
白天显著	8(72.73)	20(41.67)
呼吸道反复感染史[n(%)]	9(81.82)	18(37.50)	7.082	0.008
血清生化指标
白细胞计数[×10⁹，(±s)]	6.25±1.11	6.37±1.08	0.325	0.750
C反应蛋白[mg/L，(±s)]	3.32±0.29	3.27±0.41	0.474	0.641
中性粒细胞[%，(±s)]	58.25±10.25	57.99±7.64	0.079	0.938
嗜酸性粒细胞[%，(±s)]	4.75±1.17	4.69±1.31	0.150	0.883
血清骨膜蛋白水平[ng/ml, (±s)]	82.29±2.22	78.33±4.42	2.877	0.006
气道功能指标
FEV[%，(±s)]	88.01±12.35	87.31±10.64	0.174	0.865
FVC[%，(±s)]	92.93±13.01	91.44±12.54	0.345	0.735
FeNO[ppb，(±s)]	21.28±3.74	18.33±1.80	3.911	0.000

自变量	β	标准误	Wald	P值	OR	95%CI
自变量	β	标准误	Wald	P值	OR	下限	上限
血清骨膜蛋白水平	0.297	0.137	4.683	0.030	1.346	1.028	1.761
FeNO	0.513	0.228	5.05	0.025	1.670	1.068	2.611
呼吸道反复感染史	1.320	1.077	1.503	0.220	3.743	0.454	30.878
病程	2.325	1.187	3.839	0.050	10.228	0.999	104.676

自变量	β	标准误	Wald	P值	OR	95%CI
自变量	β	标准误	Wald	P值	OR	下限	上限
血清骨膜蛋白水平	0.297	0.137	4.683	0.030	1.346	1.028	1.761
FeNO	0.513	0.228	5.05	0.025	1.670	1.068	2.611
呼吸道反复感染史	1.320	1.077	1.503	0.220	3.743	0.454	30.878
病程	2.325	1.187	3.839	0.050	10.228	0.999	104.676

变量	AUC	SE	95%CI	特异度(%)	灵敏度(%)
血清骨膜蛋白水平	0.807	0.066	0.683~0.898	79.20	90.90
FeNO	0.769	0.103	0.641~0.869	87.50	72.70
联合	0.837	0.078	0.718~0.920	91.70	72.70

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